Provider Demographics
NPI:1437371317
Name:CENTRAL NEW YORK SERVICES, INC.
Entity Type:Organization
Organization Name:CENTRAL NEW YORK SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:315-478-2453
Mailing Address - Street 1:518 JAMES ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2238
Mailing Address - Country:US
Mailing Address - Phone:315-478-2453
Mailing Address - Fax:315-425-8917
Practice Address - Street 1:518 JAMES ST
Practice Address - Street 2:SUITE 240
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2238
Practice Address - Country:US
Practice Address - Phone:315-478-2453
Practice Address - Fax:315-425-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02857550Medicaid